Loan Application:

Apply for Loan from R250 to R4000

Loan Amount

Repayment Date

Rep Name

First name

Last name

ID Number

Address

Phone Number

Income

Additional Income

Monthly Total Expenses

Bank Name

Account Type

Account Number

Next of Kin Name

Next of Kin Phone Number

Company / Institution Name

Company / Institution Address

Company / Institution Phone

Employee / Student Number

Copy of ID

Payslip or Bank Statement

Face Picture

I hereby confirm that i can afford to repay the loan plus the monthly interest, and I agree that i will be able to repay the full amount by the specified repayment date above.

I hereby confirm that I'm not under Debt Review, Sequestration or Arbitration.

I hereby consent to the submission and processing of all of my details as represented on this application to MY CHING loan services provider and to its associated partners for the loan application.